Connective tissue autografts are commonly used as interpositional grafts between septal flaps in the repair of perforations. The most common graft materials include temporalis fascia and pericranium, both which accompanied by donor site morbidity, do not provide bulk, exceedingly thin difficult to manage.To study use an acellular human dermal allograft (AlloDerm, LifeCell Corp, Woodlands, Tex) a connective perforation repair.Private facial plastic surgery reconstructive practice 1 authors...

Correction of the lower third nose is perhaps most challenging component performing a rhinoplasty. The tongue-in-groove (TIG) technique provides method for correcting excess columellar show and maintaining correction caudal deviation. It also indicated controlling nasal tip rotation projection while preserving integrity lobular cartilaginous complex may be combined with either external or endonasal typically used in combination other septorhinoplasty maneuvers. TIG consists by which medial...

Given the increase in opioid addiction and overdose United States, reasoned use after outpatient surgery may affect prescription medication abuse.To examine patient of opioids rhinoplasty establish an optimal postrhinoplasty pain management regimen.In this case series, was evaluated 62 patients who underwent performed by 3 fellowship-trained facial plastic surgeons, 2 private practice Texas 1 academic setting Michigan, from February 2016 to September 2016.Opioid use, control, adverse effects...

Increasing nasal tip projection, rotation, and definition have classically been attempted through a variety of lobular cartilage incising or excising techniques. Resultant long-term complications, including bossing, alar notching, pinched tips, collapse, occasionally resulted from the use these The majority complications arisen secondary to loss structural support following interruption lower lateral cartilages. This article describes "lateral crural steal," method increasing projection...

• Nasal septal perforations can be technically difficult to close permanently, particularly if they are large, located posteriorly, or associated with little residual cartilage and bone. By allowing direct access the usually undisturbed dorsal septum, flaps easier elevate external septorhinoplasty approach. Also, better visualization more room in which work afforded by this approach, enabling surgeon that might using standard intranasal incisions. The technique of combined mucoperichondrial...

In 1993, Kridel and Konior published a preliminary report (in the Archives of Otolaryngology-Head Neck Surgery) on use irradiated homologous costal cartilage (IHCC) or homograft in nose. This is follow-up study to share our experience answering fundamental questions: (1) What are major long-term complications IHCC, they any greater than with patient's own cartilage? (2) Is IHCC reliable safe implant? (3) Does resorb over time? (4) measures implemented practice minimize sequelae?We performed...

<h3>Objective</h3> To assess objectively the effect of 2 cartilage-modifying techniques, lateral crural steal (LCS) and overlay (LCO), on degree nasal tip projection rotation. <h3>Design</h3> A prospective trial using computer imaging techniques for assessment. <h3>Settings</h3> Half patients were seen at a university hospital other half private practice. <h3>Patients</h3> selected series 30 seeking rhinoplasty mainly repositioning. Only with no history previous operations included....

Pronounced nasal tip ptosis is generally regarded as an unattractive facial feature. Besides its aesthetic ramifications, marked inferior displacement of the adversely affects function by restricting airflow through nares. We present a new technique that modification lateral crural flap procedure was described in 1975. This technique, which performed using open rhinoplasty approach, predictably rotates upward restructuring alar cartilages via controlled overlay crura. When overprojection...

To simplify the approach and diagnosis of alar base reduction, suggest a treatment algorithm, evaluate long-term outcomes 3 different techniques used separately or in conjunction with one another.Retrospective review 124 patients seen private practice by single surgeon. Patients ranged age from 15 to 59 years (mean age, 30.4 years). were undergoing primary (83.9%) revision (16.1%) procedures.Of 31 (25%) male 93 (75%) female. Average follow-up was 2 years. All underwent wedge excision, for 64...

Many nasal deformities require some form of graft or implant material for complete correction. Various well-recognized disadvantages are associated with currently used autografts, allografts, and alloplastic materials, thereby maintaining a continued search the ideal graft. Irradiated homograft costal cartilage is an allograft that has been variable success in head neck region. Isolated reports have suggested favorable results irradiated implantation nose. This study details findings 306...

In 1993, Kridel and Konior published a preliminary report (in the Archives of Otolaryngology–Head Neck Surgery) on use irradiated homologous costal cartilage (IHCC) or homograft in nose. This is follow-up study to share our experience answering fundamental questions: (1) What are major long-term complications IHCC, they any greater than with patient's own cartilage? (2) Is IHCC reliable safe implant? (3) Does resorb over time? (4) measures implemented practice minimize sequelae? We performed...

Abstract Septal perforation repair and septorhinoplasty (SRP) each present unique surgical challenges. However, in many instances, these procedures may be performed together successfully. In this study, the authors aim to determine safety effectiveness of combining primary or revision SRP septal via an open approach. A retrospective review was carried out all consecutive patients who had approach between 1986 2017 senior author's practice. Perforation closure surgery at patient's last...

Abstract The external septorhinoplasty incision is basically a 5 mm. across the columella connecting left and right alar margin incision. This allows retraction of dorsal skin to expose entire skeletal structure. It has great advantage both surgeon assistant for teaching studying deformed nasal anatomy, improved rhinoplasty results because it binocular visual monitoring surgery, use hands, control bleeding by electrocautery, accurate diagnosis revisional permanent sutures fix approximate...

There currently exists an overabundance of publications advocating different septal perforation repair methods. The objective this article was to examine the preponderance techniques and trends in surgical management perforations practices otolaryngologists, rhinologists, facial plastic surgeons. study designed as a multicenter cross-sectional survey. participants were members American Academy Facial Plastic Reconstructive Surgery Rhinologic Society. Septal closure rates approach, technique,...

To describe the technique for correction of soft tissue pollybeak deformity using intralesional injection triamcinolone acetonide.We discuss our philosophy, regimen, and treatment injection. We include results from a series 173 patients who underwent rhinoplasty performed by one us (N.J.P.).Triamcinolone was injected at 1 week after surgery in 127 (73%). A second 92 (72%) 4 weeks surgery. One hundred eight (85%) had an acceptable result, as judged surgeon, with good supratip definition....

To discuss the evaluation of overprojected nasal tip, present an algorithm various treatments for deprojection and introduce our experience greater than 10 years with medial crural overlay. Retrospective review a large sequential series patients undergoing rhinoplasty who were treated techniques by senior author (R.W.H.K.) from January 1, 1991, through December 31, 2002. Patients underwent preoperative postoperative during this period on regular basis to record effects approaches projection,...

Tissue expanders have been used in multiple body sites. We successfully the Radovan tissue expander scalp of patients with cicatricial alopecia and hair replacement surgery for male pattern alopecia. The is placed subgaleal plane beneath a hairbearing area inflated over six- to eight-week period. In second procedure, device removed bald excised. Closure defect accomplished, stretched replacing Scalp reduction pedicle flap procedures benefited by preliminary expansion.

The nasal tip highlights the facial profile, and in its most aesthetic configuration subtly projects anterior to dorsum create a soft supratip break. Overprojection of relation vertical plane represents one variant nasal-facial disproportion that can adversely affect an otherwise pleasant appearance. Several strategies for reducing either lateral or medial crus deproject have been suggested. This article describes method direct truncation dome using external rhinoplasty approach reliably...

Abstract The traditional rhytidectomy addresses facial and neck aging as it relates to soft tissue laxity. modern volumetric facelift provides optimal results by addressing not only skin laxity but also the loss of volume secondary atrophy bony resorption. While multiple techniques including fat grafting, dermal fillers, resuspension are used correct loss, alloplastic midface augmentation remains most permanent method. In our practice we often address cheek hollowness or with placement...